Ear Syringing/Ear Care

If there is a build up of wax in your ear(s) please read the following self-help guide as you may not need an appointment.

What is ear wax?

Ear wax is normal and is produced to form a protective coating over the skin in the ear canal.

Ears are normally self-cleaning – the movement of your jaw whilst eating and talking helps to move the wax along the canal where it will usually fall out naturally without you noticing.

Why is my ear blocked with wax?

The amount of ear wax produced varies from person to person; some people produce excessive amounts which can lead to a blockage in the ear canal.

You are more likely to develop a blockage of wax in the canal if you:

• use cotton ear buds to clean the ear as this pushes the wax deeper into the canal
• wear a hearing aid, ear plugs or use in-ear headphone - as these can all interfere with the natural process of wax expulsion
• have abnormally narrow ear canals
• have a particularly hairy ear canal
• are elderly – because the ear wax you produce is drier and harder
• have a dry skin problem such as eczema or psoriasis

Advice to help you manage and prevent ear wax blockage

Ear wax only becomes a problem if it causes deafness, discomfort or if your Health professional requires a clear view or your ear drum.

Should I use cotton buds in my ears?

Never use cotton buds in your ears! This pushes the wax further into the ear making it worse. It can also cause ear infections and damage the ear drum.

Ear Syringing

Ear syringing is only usually considered if the above recommendations have proved to be unsuccessful. Ear wax needs to be softened as above for 5-7 days before attempting to syringe. Although the  risks are low and our nurses are specially trained to perform this procedure, there is still a small chance (thought to be around 1 in 1000) of complications occurring - such as a perforated ear drum, middle ear infection, external canal infection or causing ringing in the ear (tinnitus). If your ears are regularly becoming blocked with wax, after clearing the blockage we will usually suggest you use olive oil drops
as above around once per week to keep the wax soft and encourage the natural process of wax expulsion.

Bulb syringes

What is a bulb syringe and where can I get one?

A bulb syringe is a small bulb shaped rubber object that will fill with water and allow the user to squirt the water gently into the ear to remove earwax. You can buy it from most pharmacies or online. It costs around £3 to £4.

Alternatively, there are now over-the-counter kits available from pharmacies. These contain a wax softener which you use for 3-4 days and a small bulb syringe to enable you to remove the wax from your ear canals yourself. One such kit is called Otex Express Combi Pack (costs approx £7.95). We do not advise you use this type of preparation to soften wax before having your ears syringed as longer term use can cause irritation and soreness to your ears. You may also see syringe kits specifically designed for ears (that direct the water to the sides of the ear rather than towards the drum).

When should a bulb syringe be used?

An ear bulb syringe should be used when one or both ears are blocked with wax. This is called wax impaction. The ears are usually self-cleaning as the skin cells of the ear drum and ear canal are  constantly migrating outwards and most people do not need to interfere with their ears at all. Some people make more wax or their ears do not clean the wax as effectively as others. In these cases wax can build up inside the ear sometimes causing a blockage sensation and reduced hearing.

What are the benefits of the bulb syringe?

The main benefit of the bulb syringe is that you can use it yourself without needing to make an appointment with your practice nurse or GP. It is cheap to buy and can be re-used.

How effective is the bulb syringe?

A study on the use of the bulb syringe showed that half of patients who use it are successfully treated. Ear syringing by a practice nurse has been proven to be slightly more effective but it may be  sensible to try the ear bulb syringe first.

Is it safe and what are the risks of using a bulb syringe?

The use of the bulb syringe is commonly used in the USA or Europe. Two studies have shown the bulb syringe to be a safe treatment.

The risks of using the bulb syringe include failure to remove the wax and ear infection. These risks are low.

What if my ears are still blocked after using the bulb syringe?

The procedure can be repeated but if it fails make an appointment to have your ears examined. If self syringing is unsuccessful you may be referred for ear syringing or microsuction elsewhere.

How do I use the bulb syringe?

The bulb syringe will most likely come with instructions but below is some advice on how to use the bulb syringe (you may need a family member to help you but it really is very simple):

1. Firstly, use olive oil or sodium bicarbonate eardrops in the ear daily for 2-3 weeks. Apply a generous amount twice daily into the ear leaving the ear uppermost for 5-10 minutes after applying. If this does not clear the wax then the bulb syringe can be used.
2. Put some clean warm (not hot) water in a bowl. Squirt the bulb syringe in the water a few times to fill it up with warm water.
3. Hold your head to one side so the affected ear is facing upwards. You can do this in the shower or bath or lie on the bed with a towel underneath your head.
4. If you experience any pain during or before this procedure stop immediately and see a practice nurse or GP for a review.
5. Gently pull your ear in an upwards and outwards direction so that the water gets better access to the ear canal. Hold the nozzle inside the ear (not too deeply) and gently squirt the water from the bulb syringe into the ear. You can gently squirt more bulb syringes into the ear if require. Leave the water in your ear for 1-3 minutes to soften the wax.
6. Now tilt your head over so the water can fall out. Wiggle the outer part of the ear to help the water and wax come out. You can repeat the procedure if required.
7. Repeat for the other ear if both ears are affected.
8. If you get any pain or if the procedure is unsuccessful, see a practice nurse or GP.

Do I have to treat ear wax impaction (blocked ears from wax)?

No. If your ears being blocked with wax does not particularly trouble you then you do not have to treat it. You can use olive oil or sodium bicarbonate drops daily and this will help the ears clean  themselves. You can get these drops over the counter in any pharmacy.

Can I go elsewhere for ear syringing or microsuction?

There are some local options for having ear wax removed privately.